The experiences of registered nurses' of their work environment in a critical care unit
- Authors: Adams, Bernardene Lucreshia
- Date: 2009
- Subjects: Intensive care nursing -- South Africa , Intensive care units , Nurses -- Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10013 , http://hdl.handle.net/10948/1057 , Intensive care nursing -- South Africa , Intensive care units , Nurses -- Job stress -- South Africa
- Description: Critical care nursing is a vital and significant part of health care provision to critically ill patients. It is a specialty area of nursing that requires registered nurses who are highly motivated, knowledgeable and skilled to provide optimal care to critically ill patients. These patients are nursed in a complex environment consisting of specialised equipment (such as ventilators, defibrillators, intravenous pumps, and cardiac monitors) that is not found in any other field of nursing. Collegial support and an adequate registered nurse: patient ratio is vital in critical care units in order to provide optimal quality care to critically ill patients. However, an understaffed work environment, the demands of critical care nursing and other work-related problems, such as conflict with physicians, inadequate remuneration packages and an increased workload can cause serious distress and dissatisfaction amongst registered nurses in this specific environment (Carayon & Gürses, 2005:287). The objectives of this study therefore are to explore and describe the experiences of registered nurses of their work environment in a critical care unit and to make recommendations that will assist registered nurses working in a critical care unit. A qualitative, explorative, descriptive and contextual research design will be utilised. Data will be collected by means of semi-structured interviews and analysed according to the framework provided by Tesch (in Cresswell, 2003:192). Purposive sampling will be used to select a sample of registered nurses working in a critical care environment. Guba’s model (in Krefting, 1991) will be utilised to verify data and to ensure trustworthiness of the study. Ethical considerations will be adhered to throughout the study. Once data has been analysed, recommendations will be made that will assist registered nurses working in a critical care unit.
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- Date Issued: 2009
Registered nurses' perceptions of factors causing stress in the intensive care environment in state hospitals
- Authors: Beau, S P
- Date: 2006
- Subjects: Intensive care nursing -- South Africa , Nurses -- Job stress -- South Africa , Stress management -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10044 , http://hdl.handle.net/10948/457 , Intensive care nursing -- South Africa , Nurses -- Job stress -- South Africa , Stress management -- South Africa
- Description: The complex environment of an intensive care unit is associated with a considerable amount of stress. Intensive care nurses are confronted daily with increasing work demands, emanating from the growing numbers of critically-ill patients; the introduction of highly sophisticated technologies in the intensive care environment; increasing competition between health care institutions; increased work loads; and limited career opportunities caused by, among other things, budget cuts by the government (Janssen, De Jonge & Bakker, 1999:1360). Research has shown that such stressors can result in mental, physical and behavioural stress reactions among nurses (Demerouti, Bakker, Nachreiner and Schaufeli, 2000:454). The objective of this study is to explore and describe registered nurses’ perceptions of factors causing stress in intensive care environments of state hospitals. The main purpose of the study is to develop guidelines for a stress management programme, to assist registered nurses to cope with the stressors in an intensive care environment. The research design is placed within a quantitative, explorative and descriptive contextual framework. Validity and reliability in testing and evaluating the research questionnaire are discussed, as well as the ethical and legal considerations relating to this research study. Findings of the research study will be utilized to assist the researcher in developing guidelines for a stress management programme to assist registered nurses in coping with stress in an intensive care environment
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- Date Issued: 2006
The relationship between organisational culture, transformational leadership and organisational change outcomes in public intensive care units
- Authors: Befile, Nomawethu
- Date: 2017
- Subjects: Critical care medicine -- Leadership Organizational behavior , Organizational change Leadership
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/14576 , vital:27794
- Description: Organisational change in any organisation, including the healthcare industry, implies a change in organisational culture. The concept of organisational culture refers to those values and norms within an organisation that are prescribed by both the employer and the employees as to how to behave. However, organisational culture should not be viewed in isolation, as culture and leadership are intertwined. Transformational leadership within an organisational culture serves to achieve its goal, missions and aims by influencing, motivating and creating a mutual relationship between employees and employers, which brings about effective organisational change. The alignment of organisational culture and leadership with a hospital’s vision is important to ensure optimal healthcare delivery and organisational change outcomes. A positivistic research paradigm, with a quantitative, explorative, descriptive and contextual approach, was used to conduct the research study. The research study explored whether a supportive organisational culture, transformational leadership and organisational change outcomes were prevalent in public intensive care units. Secondly, the study aimed to investigate the relationship between organisational culture, transformational leadership and organisational change outcomes in public intensive care units in the Nelson Mandela Bay. Data was collected by means of a structured and previously validated questionnaire with a Cronbach’s alpha of more than 0.80. The target population was registered nurses who work in the intensive care units in the public hospitals. The sample was composed of 56 registered nurses and 4 enrolled nurses who were selected from public hospital intensive care units in Nelson Mandela Bay. Descriptive statistics, linear regression analysis, correlation and a Chi-square test were used to describe the hypothesised relationship between organisational culture and transformational leadership (independent) with organisational change outcomes (dependent variable). The results of this study revealed that the alternative hypothesis was accepted as the P value, was less than 0.05 in all variables. This proved that there was a significant relationship between organisational culture, transformational leadership and organisational change outcomes in the public intensive care units which were sampled. Recommendations are made as to how organisational culture can enhance and support transformational leadership and organisational change outcomes to promote a positive change outcome in public intensive care units. Ethical considerations were maintained throughout the research study.
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- Date Issued: 2017
Experiences of professional nurses with regard to accessing information at the point-of-care via mobile-computing devices at a public hospital
- Authors: Benjamin, Valencia
- Date: 2013
- Subjects: Information storage and retrieval systems -- Hospitals , Point-of-care testing , Public hospitals -- Medical staff
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10060 , http://hdl.handle.net/10948/d1020193
- Description: Mobile computing devices are capable of changing how healthcare is delivered in the future, since they aim to merge and integrate all services into one device that is versatile, customisable, and portable. The aim of this study was to explore and describe the experiences of professional nurses with regard to accessing information at the point-of-care of the patient, in order to develop guidelines that could assist other professional nurses with implementing the mobile computing device for accessing information at the point-of-care of patients. To achieve the purpose of the study, a qualitative, explorative, descriptive, and contextual design was used to conduct this research – to gain an understanding of how the professional nurses experienced accessing information at the point-of-care via mobile computing devices. The study was conducted among the professional nurses employed at the public hospital, who were trained and provided with the mobile computing device for accessing information at the point-of-care for more than two years. In-depth interviewing was conducted to obtain the data. Data analysis was done using Tesch‘s method to make sense out of text and data. Four themes were identified, namely, the professional nurses‘ expression of various experiences regarding the training received; the need for support in implementing the mobile computing device; the accessing of information at the point-of-care as beneficial for educational purposes; and the accessing of information at the point-of-care as beneficial to patient care. Two main guidelines were developed. The study concludes with recommendations made with regard to the areas of nursing practice, education and research. Throughout the study, the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2010:298).
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- Date Issued: 2013
Barriers to implementation of evidence-based practices in a critical care unit
- Authors: Bowers, Candice Andrea
- Date: 2013
- Subjects: Evidence-based medicine , Critical care medicine , Nursing ethics
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10048 , http://hdl.handle.net/10948/d1013612
- Description: Over the last three decades there has been a greater need for health care practitioners to base their decision on the best available in order to optimise quality and cost-effective patient care. Evidence-based practice necessitates guideline development, education and review in order to achieve improved patient outcomes. However, initiatives that endeavour to disseminate and implement evidence-based practice have faced barriers and opposition. Barriers that might hamper the implementation of evidence-based practice include characteristics of the evidence itself, personal, institutional or organizational factors. The research study explored and described the barriers to implementation of evidence-based practices in a critical care unit. Based on the data analysis, recommendations were made to enhance the implementation of evidence-based practices in the critical care unit. A quantitative, explorative, descriptive and contextual research design was used to operationalize the research objectives. The target population comprised professional nurses in the critical care unit. Non-probability sampling was used to obtain data by means of a structured self-administered questionnaire. Descriptive data analysis was applied, using a statistical programme and the aid of a statistician. The results are graphically displayed using bar graphs and tables. Recommendations for nursing practice, education and research were made. Ethical principles have been maintained throughout the study.
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- Date Issued: 2013
Teaching strategies to facilitate active learning in a private nursing education institution
- Authors: Choonara, Shereen Mohammed
- Date: 2017
- Subjects: Nursing -- Study and teaching -- South Africa Nursing schools -- South Africa , Nurses -- In-service training -- South Africa College teaching -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/14829 , vital:27878
- Description: Nurse educators are the custodians of nursing education and are faced with the task of providing quality nursing education in a way that inspires and enhances learning. The approach to teaching has moved away from the traditional teacher centre approach to a more student centred, active learning approach. Nurse educators are faced with many challenges, such as creating a learning environment that is conducive to a new and diverse generation of students who have different needs, learning styles and expectations. It is therefore important that the nurse educators strive to enhance the overall learning experience by incorporating teaching strategies that engage students as active participants in the learning process. This study followed a quantitative, descriptive, exploratory and contextual research design in order to determine the activities, educational resources and teaching strategies used to facilitate active learning in a private nursing education institution. The target population was comprised of student nurses registered at the private nursing education institution. The data was collected by means of a self-administered questionnaire from 721 participants at learning centres throughout the country. The statistician used Statistica Version 12 to obtain both a descriptive and a statistical summary of the data. Descriptive statistics were used to describe the common features of the data used and the findings were discussed and summarized in tables and graphs. The ethical principles of informed consent, confidentiality and anonymity, beneficence, non-maleficence, veracity and justice have been maintained throughout this study. This study was conducted in one private nursing education institution in South Africa and only focussed on student nurses. The findings were that the greater majority of the students were encouraged to actively participate in the classroom. Students voiced their preference regarding the activities and teaching strategies utilized. There is disparity and inequality regarding the availability of educational media, resources and facilities. A variety of teaching strategies were utilized in the classrooms of the private NEI, but the use of technology based teaching strategies was limited. Information obtained from nurse educators could provide clarity on their use of teaching strategies to facilitate active learning in the classroom or at least highlight gaps in their knowledge that could help to facilitate training for nurse educators. Based on the findings of the study, recommendations for nursing practice, research and nursing education were made. The main recommendations for nursing education include the continuation of active learning activities given by the nurse educators in the classroom. Nurse educators to take cognisance of the students’ preferences and justify their selection of teaching strategies. The private NEI should ensure the availability and accessibility of educational resources, multimedia and facilities that are essential in teaching students to become self-directed, independent practitioners. Opportunities should be made available for nurse educators to attend seminars or workshops on the use of technology-based teaching strategies and undergo training in the utilization of different strategies that can enhance active learning. This could be included as a mandatory module of the nurse educators’ continuous professional development.
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- Date Issued: 2017
Knowledge, attitudes and practices of adolescents regarding contraceptives in the Maluti sub-district
- Authors: Cingo, Andiswa Linda
- Date: 2017
- Subjects: Contraceptives -- South Africa -- Eastern Cape Teenagers -- Sexual behavior -- South Africa -- Eastern Cape , Teenagers -- South Africa -- Eastern Cape -- Attitudes Adolescence -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/15302 , vital:28217
- Description: The researcher observed a high incidence of pregnancy, sexually transmitted infections and abortions, including illegal abortions among adolescents in the Maluti Sub-District in the Eastern Cape Province. The researcher noted when speaking to the adolescents about contraceptives that they appeared to have a lack of knowledge as well as some misconceptions about contraceptives. The study therefore explores the knowledge, attitudes and practices of adolescents regarding contraceptives. To achieve the purpose of this study, a quantitative, explorative and descriptive survey was used to conduct this study. The research population in this study comprised all Grade 11 and 12 female adolescents enrolled at the selected senior secondary schools in the Maluti Sub-District. Simple random sampling was used to select the research sample. A structured self-administered questionnaire was used as a data collection tool. Descriptive and inferential statistics were used with the help of a statistician to analyse the data. A pilot study was conducted prior to the actual study being conducted, using the same design and research methods. The study findings revealed that participants had a low level of knowledge about contraceptive methods and there were some misconceptions regarding contraceptives prevailing among the participants. More than half (54%) of the participants are currently sexually active and less than a third of the participants indicated that they were using contraceptives The study concludes with recommendations for nursing practice, education and research. Ethical principles have been maintained throughout the study.
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- Date Issued: 2017
The lived experiences of professional nurses with regards to end-of-life issues in the Intensive Care Unit
- Authors: Clifford, Ilzé
- Date: 2013
- Subjects: Intensive care units , Death
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10055 , http://hdl.handle.net/10948/d1018572
- Description: Professional nurses working in an intensive care unit (ICU) are faced with the death of critically ill patients frequently. Modern day medicine and technology have made it possible for advanced life-sustaining measures to be implemented on patients who, without medical intervention, would otherwise not have survived. The question is raised: is modern technology preserving life and prolonging the dying process, or is it in the best interest of the patient for treatment to be withdrawn? Nurses, caring for these patients and their families, are practicing at the bedside of these dying patients and are thus often faced with end-of-life issues, particularly withdrawal of treatment. The primary functions of critical care nurses are toward their patients. Physicians are responsible for making decisions regarding withdrawal of treatment. However, the nurses in the ICU are responsible for implementing the decisions made; sometimes contradicting what they believe in. The experience of end-of-life issues, namely withdrawal of treatment, is a cause of distress for the professional nurse. Little research has been done on how the ICU nurses deal with end-of-life issues and what support structures are required to assist nurses in dealing with end-of-life issues (Hov, Hedelin & Athlin, 2006:204) The objectives of the study were to explore and describe the professional nurses‟ lived experiences of end-of-life issues in the intensive care unit. The study aimed to make recommendations regarding support strategies to assist professional nurses in dealing with end-of-life issues in the intensive care unit. The researcher has selected a qualitative research approach with an explorative, descriptive and contextual design in order to conduct the study. Data was collected by means of semi-structured interviews. Data was analysed using the steps as illustrated by Tesch‟s method. Ethical principles were maintained throughout the research study. The findings of this study are to be presented in a journal publication.
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- Date Issued: 2013
Experiences of midwives caring for mothers who have lost their babies at birth
- Authors: Dasi, Peggy
- Date: 2016
- Subjects: Obstetrics , Midwives , Perinatal death -- Psychological aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/9000 , vital:26454
- Description: Midwives working in labour wards usually have the pleasure of delivering a live baby and rejoicing with the mother. However, the delivery could become tragic for the mothers and midwives when the baby dies at birth due to pregnancy related complications. The result is that midwives have to render care and support to mothers who have lost their babies at birth. The objectives of this study were to explore and describe the experiences of midwives caring for mothers who have lost their babies at birth. A qualitative explorative, descriptive and contextual design was used to conduct this research study to gain an understanding of how the midwives experienced caring for mothers who have lost their babies at birth. A purposive criterion based non-probability sampling method was used. Ten semi-structured face-to-face interviews were conducted to collect data. Ethical considerations were observed throughout the research study. Measures of trustworthiness were ensured by using credibility, transferability, dependability and conformability. Data analysis was done using Tesch’s method to make sense out of text and data. Four themes were identified, namely, Midwives shared their diverse experiences relating to caring for mothers who have lost their babies at birth; Midwives expressed how their personal values and beliefs influenced the ways they dealt with babies dying at birth; Midwives described the organizational values and beliefs related to death and dying and how this influences their own experiences and lastly Midwives provided suggestions regarding how they can be assisted in caring for mothers who have lost their babies at birth. Two main guidelines were developed based on the research findings and literature. The study concludes with recommendations made with regard to areas of nursing practice, education and research.
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- Date Issued: 2016
Die ervaring van die geregistreerde verpleegkundedosent ten opsigte van die kliniese begeleiding van verpleegstudente
- Authors: De Wet, Annemie
- Date: 2014
- Subjects: Nursing students , Mentoring in nursing -- South Africa
- Language: Afrikaans
- Type: Thesis , Masters , MCur
- Identifier: vital:10053 , http://hdl.handle.net/10948/1018275
- Description: Die doel van die studie was om vas te stel hoe die verpleegkundedosent die begeleiding van verpleegstudente in die praktyk ervaar. In die verlede was begeleiding van verpleegstudente met praktika in gesondheidsorginstansies deur ʼn professionele verpleegkundige gedoen wat deel was van die personeel se verantwoordelikhede. Die verpleegstudente doen hul teoretiese kennis op by ʼn tersiêre instansie en verkry hul praktiese kennis by ʼn geakkrediteerde gesondheidsorginstansie soos vereis deur die Suid-Afrikaanse Raad op Verpleging (SARV). Een van die take van ‘n verpleegkundedosent van die privaat opleidingskool is om die kliniese begeleiding van verpleegstudente in geakkrediteerde instellings te doen. Omdat verpleging ʼn beroep is waar vaardighede belangrik is, is praktiese inoefening van prosedures en evaluering van die verpleegstudente se vaardigheid daarin noodsaaklik. Die verpleegstudente is heeltyd besig met die pasiënte in die vorm van prosedures waarby die teorie wat in die opleidingskool verkry was, gekorreleer moet word met die prosedure om die hele prentjie te vorm. Dit is dus nodig dat begeleiding van die verpleegstudente gedoen moet word om vaardigheid en toepassing van kennis te verseker. Die navorser het ʼn kwalitatiewe, ondersoekende, beskrywende en kontekstuele studie gedoen waarvan die populasie die geregistreerde dosente van verskeie provinsiale en privaatverpleegskole in die Klein-Karoo en Suid-kaapdistrikte was. Die navorser het gebruik gemaak van ʼn nie-waarskynlike steekproef. Inligtingryke data was ingesamel deur semi-gestruktureerde onderhoude wat aangevul was met veldnotas soos verkry tydens onderhoude. Data-ontleding was reeds begin met data-insameling en Tesch se inhoudsontleding was gebruik om ʼn mening te vorm. ‘n Literatuurkontrole was gedoen om te bepaal wat vorige navorsing oor begeleiding bevind en aanbeveel het. Lincoln en Guba se model was gebruik vir betroubaarheidsversekering volgens die kriteria wat hulle aanbeveel het, naamlik geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid. Uit die data-ontleding het vier belangrike temas en subtemas te voorskyn gekom. Die temas was dat die verpleegkundedosente aspekte van die begeleiding van verpleegstudente in die gesondheidsorginstansie as positief en ook as negatief beleef. Die wyse waarop die gesondheidsorginstansies bestuur word, het die begeleiding beïnvloed en daar was riglyne voorgestel wat die kliniese personeel en dosente kan rig wanneer hulle betrokke raak by die begeleiding van verpleegstudente. Die begeleiding van verpleegstudente deur verpleegkundedosente, kliniese dosente en die gesondheidsorginstansie se opgeleide personeel, is ʼn belangrike deel van verpleegopleiding en bepaal uiteindelik die kwaliteit van die pasiëntsorg wat verskaf word deur die verpleegkundiges. Die navorser het riglyne daar gestel om die begeleiding van vepleegstudente te rig. Die riglyne moet nou geïmplementeer en getoets word binne die konteks van die bepaalde verpleegskole en dan weer geëvalueer word. Beperkings wat ondervind was in die studie was dat die steekproef ʼn klein groepie verpleegkundedosente op die platteland was, wat veralgemening bemoeilik, veral in die stedelike konteks. Die begeleiding van die verpleegstudente is gedoen met die ingeskrewe verpleegstudente (Die Suid-Afrikaanse Raad op Verpleging Regulasies, Regulasie 2176 en 2175 van 19 November 1993), naamlik die kategorie met die minste status en verantwoordelikheid onder verpleegstudente. Veralgemening na alle kategorieë, veral verpleegstudente besig met professionele verpleegprogramme, mag dus nie sinvol wees nie.
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- Date Issued: 2014
Professional nurses' knowledge regarding weaning the critically ill patient from the mechanical ventilation
- Authors: Demingo, Xavier Preston
- Date: 2011
- Subjects: Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10026 , http://hdl.handle.net/10948/1323 , Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Description: Mechanical ventilation (MV) is one of the most frequently used treatment modalities in the intensive care unit (ICU) (Burns, 2005:14). Up to 90% of critically ill patients in ICUs globally are connected to a mechanical ventilator. Although mechanical ventilation is a lifesaving intervention, it is expensive and is associated with diverse complications (Mclean, Jensen, Schroeder, Gibney & Skjodt, 2006: 299). Ventilator-associated pneumonia (VAP) accounts for 25% of all infections in ICU, with global crude mortality figures estimated at 20-70% (Craven, 2006:251). Minimising the time that a patient is connected to a mechanical ventilator to the absolute minimum can have considerable benefits in terms of decreased mortality and morbidity, as well as a decreased length of ICU stay and lower hospital costs. Critically ill patients therefore need to be weaned from the mechanical ventilator as soon as their condition that warranted the need for mechanical ventilation is stabilized. The process of weaning the critically ill patient from mechanical ventilation constitutes a significant proportion of total ventilator time. As professional nurses attend to the mechanically ventilated patient 24 hours a day, they have a vital role to play in the collaborative management of the patient requiring weaning from mechanical ventilation. The objectives of this study were to explore and describe the professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. Based on the results, recommendations in the form of a protocol were made in order to improve the professional nurses’ knowledge and enhance the care of the mechanically ventilated patient. A quantitative design, which was exploratory, descriptive and contextual in nature, was utilised for the study. The data collection instrument of choice was a self-administered questionnaire. Convenience, non-probability sampling was the sampling method chosen for the purpose of this study. Collected data were analysed with the assistance of a statistician using descriptive and inferential statistics. Results were displayed in the form of graphs and tables. The results obtained in the study, combined with data from the literature review, were used to develop recommendations to enhance vi professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. The recommendations were presented in the form of a protocol based on the available evidence. Ethical principles as they relate to conducting research were adhered to throughout the study.
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- Date Issued: 2011
Guidelines for psychiatric nurses to assist in the care of female patients with bipolar disorder during their admission and stay in a tertiary level psychiatric facility in the Eastern Cape, South Africa
- Authors: Du Plessis, Anneki
- Date: 2015
- Subjects: Psychiatric nurses -- South Africa -- Eastern Cape , Manic-depressive persons -- South Africa -- Eastern Cape , Psychiatric hospitals -- Admission and discharge -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10072 , http://hdl.handle.net/10948/d1021160
- Description: Bipolar disorder is the sixth leading cause of disability in the world among people aged 15-44. Bipolar disorder is a chronic psychiatric disorder with a significant impact on patients’ social, occupational, and general functioning well-being. Patients who are diagnosed with bipolar type 1 disorder are usually admitted to a psychiatric hospital as an involuntary patient which means that they will be cared for in a closed unit. In a critical analysis of the literature it was noted that not much is known of the experiences of patients in psychiatric wards. The researcher used a qualitative approach, with a phenomenological research strategy. An explorative, descriptive and contextual design was utilized to gain more insight into female patients’ lived experiences during their admission and stay in a tertiary level psychiatric institution. The research population was female patients who were diagnosed with bipolar disorder and who had recently experienced being admitted to and treated at a tertiary level psychiatric facility where they were treated for this condition. Purposive sampling was utilised to obtain the sample for the study. A pilot study was conducted before the study commenced to ensure the trustworthiness of the findings. The researcher obtained the data via semi-structured interviews as well as field notes and reflective journals. Data was analysed by using Tesch’s method as adopted by Creswell. Once the data had been analysed, a literature control was done in accordance with the findings. Guba’s model of trustworthiness was utilized to ensure that this study was trustworthy and credible. The researcher implemented ethical principles to ensure that no harm was done to the participants during the research study. Finally, guidelines were developed to assist professional nurses to manage patients optimally during their admission and stay in a closed unit of a tertiary psychiatric facility.
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- Date Issued: 2015
Knowledge of midwives at Community Health Centres and Midwife Obstetrics Units in the Nelson Mandela Bay regarding the use of the Road-to-Health Chart
- Authors: Dumisani-Ndlovu, Sidumisile Charity , Sonti, Balandeli S I , James, S
- Date: 2017
- Subjects: Children -- South Africa -- Nelson Mandela Bay Municipality -- Growth , Midwifery -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/21692 , vital:29733
- Description: The challenge of child mortality between the ages of 0 and 5 years has extensively increased over the past few years. Furthermore, the ever-evolving and complex consequences of ineffective monitoring of children’s growth and development have been identified as one of the reasons for this increase in child mortality. The Road-to-Health Chart was developed and redesigned for use by child nurses and midwives to monitor children’s growth and development. The purpose of this study was to investigate whether the midwives at community healthcare centres in the Nelson Mandela Bay area had the necessary knowledge to utilise the Road-to-Health Chart effectively. Permission to conduct the study was sought from the Nelson Mandela Metropolitan University, the Department of Health and the participants. A quantitative, non-experimental descriptive survey was used in this research. The population consisted of all the midwives working in the Midwife Obstetric Unit and community healthcare centres within the Nelson Mandela Bay Municipal area. The sample was extracted from the targeted population but from willing participants that met the inclusion criteria. The research data-collection method was a self-developed questionnaire with closed-ended statements to measure the knowledge of how effectively the midwives in the Nelson Mandela Bay area were using the RTHC. The researcher ensured the validity of the questionnaire by focusing on the instrument’s validity, construct validity, content validity and face validity. Ethical considerations, including permission, informed consent, confidentiality and anonymity, were adhered to. The most significant findings showed that midwives at CHCs and MOUs in the Nelson Mandel Bay area were knowledgeable about the importance of the RTHC to the mother and child and the use of the RTHC. These findings may assist in the identification of measures to enhance the knowledge of midwives about the use of the RTHC thus ultimately facilitating the use of the RTHC by mothers as intended.
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- Date Issued: 2017
Professional nurses experiences of a team nursing care framework in critical care units in a private healthcare group
- Authors: Dunsdon, Jeananne
- Date: 2011
- Subjects: Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10022 , http://hdl.handle.net/10948/1444 , Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Description: A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.
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- Date Issued: 2011
Lived experiences of professional nurses caring for mechanically ventilated patients
- Authors: Else, Liana
- Date: 2015
- Subjects: Respiratory intensive care , Respiratory therapy , Respirators (Medical equipment) , Artificial respiration
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/8295 , vital:26320
- Description: Critical care nursing is a speciality that continues to evolve and transform. Critical care nurses of the 21st century routinely care for the complex, critically ill patient, integrating sophisticated technology with the accompanying psychosocial challenges and the ethical conflicts associated with critical illness – while, at the same time, addressing the needs and concerns of the family. Providing nursing care in such a dynamic and fast-track unit can pose various challenges for the critical care nurse. Professional nurses are the backbone of any health-care system. The quality of nursing directly affects the patients’ outcomes, and nursing care must therefore be rendered meticulously. Mechanical ventilator support is routinely needed for critically ill adults in these care units and is also a common therapy in sub-acute and long-term care settings. The care of the mechanically ventilated patient is the core of a professional nurse`s practice in the critical care unit. The mechanically ventilated patient presents many challenges for the professional nurse, while the critical care unit poses as a stressful environment for the professional nurse as well as the patient. The objectives of this study therefore were to explore and describe the lived experiences of professional nurses while caring for mechanically ventilated patients, and to develop recommendations to support professional nurses while caring for mechanically ventilated patients. A qualitative, explorative, descriptive and contextual research design was utilised. Data was collected by means of semi-structured interviews and analysed according to the framework provided by Tesch. Purposive sampling was used to select a sample of professional nurses working in a critical care environment. Guba’s model was utilised to verify data and to ensure trustworthiness of the study. Ethical principles were adhered to throughout this research study. With the analysed data, recommendations were to support professional nurses while caring for mechanically ventilated.
- Full Text:
- Date Issued: 2015
Endotracheal tube verification in the mechanically ventilated patient in a critical care unit
- Authors: Fataar, Danielle
- Date: 2013
- Subjects: Respirators (Medical equipment) , Critical care medicine , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10020 , http://hdl.handle.net/10948/d1008057 , Respirators (Medical equipment) , Critical care medicine , Intensive care units
- Description: Critically ill patients often require assistance by means of intubation and mechanical ventilation to support their spontaneous breathing if they are unable to maintain it. Mechanical ventilation is one of the most commonly used treatment modalities in the care of the critically ill patient and up to 90% of patients world-wide require mechanical ventilation during some or most parts of their stay in critical care units Management of a patient’s airway is a critical part of patient care both in and out of hospital. Although there are many methods used in verifying the correct placement of the endotracheal tube, the need and ability to verify placement of an endotracheal tube correctly is of utmost importance, because many complications can occur should the tube be incorrectly placed. Since unrecognized oesophageal intubation can have many disastrous effects on patients, various methods for verifying correct endotracheal tube placement have been developed and considered. Some of these methods include direct visualization, end-tidal carbon dioxide measurement and oesophageal detector devices. This research study aimed to explore and describe the existing literature on the verification of endotracheal tubes in the mechanically ventilated patient in the critical- care unit. A systematic review was done in order to operationalize the primary objective. Furthermore, based on the literature collected from the systematic review, recommendations for the verification of the endotracheal tube in the mechanically ventilated patient in the critical care unit were made. Ethical considerations were maintained throughout the study and the quality of the systematic review was ensured by performing a critical appraisal of the evidence found.
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- Date Issued: 2013
Midwives' experiences regarding the utilization of partographs in a Namibian Regional Hospital
- Authors: Fernandes, Diina
- Date: 2015
- Subjects: Midwifery -- Namibia , Labor (Obstetrics) -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10071 , http://hdl.handle.net/10948/d1021158
- Description: Labour has been characterized as the most dangerous journey a woman undertakes. The reason being, that although it is a natural process, many labouring women suffer complications during labour and childbirth including prolonged or obstructed labour. These complications can result in maternal and infant morbidity and mortality. The partograph is a monitoring tool that can provide a continuous pictorial overview and is essential to monitor and manage labour. It is recommended by the WHO for use universally by midwives while monitoring labour. However partographs are poorly utilized and most parameters on the partograph are not monitored and findings after reviewing a labouring woman are not documented on the partograph. It is unclear how midwives working in Namibian Health services experience and utilize the partograph during the monitoring of a woman in labour. These may be the factors that hinder the effective utilization of the partograph. The objective of this study was to explore and describe the experiences of midwives regarding the utilization of the partograph for monitoring a labouring woman in a Namibian regional hospital in order to develop guidelines based on the findings to improve the use of the partograph by midwives in order to improve the management of labour. The research design was qualitative, descriptive, explorative and contextual in nature. The research population consisted of midwives working in a regional hospital in Namibia. A purposive and convenient sampling method was used to select participants. Specific inclusion criteria were met and consent was obtained from the participants and from the Regional Health Directorate Management of the hospital where the research was conducted. Interviews were conducted by an independent interviewer within the Department of Health to ensure an unbiased viewpoint. Data were collected by means of semi-structured in depth interviews with a guide, using an audio tape recorder. Field notes were used to record non- verbal communication. As soon as data were saturated, the interviews were stopped. They were then transcribed, verbatim and analysed using the Tesch’s approach as described in (Creswell, 2009:186). The service of an independent coder was utilized to ensure trustworthiness. Trustworthiness was further ensured by using the strategies suggested by Lincoln and Guba’s model, namely credibility, transferability, dependability and confirmability. Ethical considerations were honoured throughout by adhering to ethical principles during the study. These included ensuring that the participants` rights were respected, they were not harmed and fairness were ensured. On completion of the data analysis a literature control was conducted and existing literature was compared to the findings in order to identify similarities and differences and to verify whether the literature supported the findings. Four main themes that emerged during data analysis are: Theme 1.Midwives found it a positive experience to use the partograph when caring for a woman in labour. Theme 2. When a midwife experienced problems in using the partograph, it may lead to detrimental outcomes. Theme 3. Utilizing the partograph evoked differing emotions in midwives. Theme 4. Midwives` knowledge and skills in the utilization of the partograph should be updated regularly. By describing the lived experienced of midwives in the maternity ward on the use of the partograph, the midwives had a positive attitude to using the partograph, but they also found it difficult to utilize the instrument as was directed by the (WHO) due to challenges experienced such as: unrealistic staff/patient ratio, shortage of staff, time consuming, insufficient knowledge and skills among midwives and lack of appropriate equipment. There is a specific need to prevent further negative emotions by addressing the challenges experienced. Based on the findings, guidelines for partograph utilization which aimed at improving the midwifery care were developed. Recommendations were made regarding midwifery education, clinical midwifery care and midwifery research.
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- Date Issued: 2015
The relationship between organisational contextual factors and clinical practice guideline implementation in private critical care units
- Authors: Flippies, Emirenthia Emogin Elouise , Venter, D J L
- Date: 2016
- Subjects: Medicine -- Practice -- Standards -- South Africa Medical care -- Standards , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/12583 , vital:27096
- Description: Clinical practice guidelines are one way of ensuring that healthcare is based on the evidence-based practices. In a dynamic unit, like the critical care unit, where sound decision-making and critical thinking are required in the care of critically ill patients, the implementation of such guidelines for care is of utmost importance. Guideline implementation is however not so simplistic, and various studies have proven that there are various barriers linked to guideline implementation. However, most the barriers have proven to be related to individual factors. Therefore, a greater focus has been placed on organisational contextual factors that might have an influence on clinical practice guideline implementation. The research study followed a positivistic, quantitative paradigm, where the hypothesised relationship between the organisational contextual factors and clinical practice guideline implementation were investigated. A structured pre-existing questionnaire, namely the Alberta Context Tool, was used to collect data from 65 registered nurses in private critical care units. Descriptive and inferential statistics were used to analyse the data. The findings revealed that although the organisational contextual factors were prevalent in the private critical care units sampled, some factors like leadership and culture scored higher than the other factors. Positive relations were reported between the organisational contextual factors and clinical practice guideline implementation. The results imply that the alternative hypothesis H1 is supported, and thus proved that there are significant relationships between organisational contextual factors and clinical practice guideline implementation in private critical care units in the East London area.Recommendations were made on how to enhance organisational contextual factors in the implementation of clinical practice guidelines. Ethical principles were maintained throughout the study.
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- Date Issued: 2016
Experiences of women who gave birth before arrival at a midwife obstetric unit
- Authors: Fouché, Moira Sandy
- Date: 2016
- Subjects: Midwifery -- South Africa -- Nelson Mandela Bay Municipality , Pregnant women -- South Africa -- Nelson Mandela Bay Municipality , Maternity nursing -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/7176 , vital:21290
- Description: Pregnant women expect to give birth in a safe environment conducive to a safe delivery such as the hospital. In some cases the birth does not always work out as planned as labour is unpredictable and circumstances may lead to the woman giving birth before arriving at the hospital. For some women the outcome of the experience could have a positive effect while most of the time it is a negative effect such as embarrassment and disappointment. The researcher, an experienced midwife, observed in the unit where she works of the steady increase in women who were admitted as experiencing birth before arrival. The women will at times be reluctant to respond to questions on admission regarding their labour process and also tend not to focus on the needs of the baby. When the mother is discharged, one is left wondering what will happen to the infant at home. Hence, this study had the following objectives: to explore and describe the women’s experiences of giving birth before arrival at a midwife obstetric unit in the Nelson Mandela Bay Municipal area and secondly, to use the findings of the study to make recommendations to assist midwives to support women who have experienced birth before arrival at a midwife obstetric unit. This study was a qualitative, explorative, descriptive and contextual research study. The research population included all the women who had birth-before-arrival deliveries at the midwife obstetric unit in the Nelson Mandela Bay Municipal area. The criteria for inclusion were women who had experienced birth before arrival between October 2014 and December 2014; women who had been admitted to an midwife obstetric unit and not referred to a tertiary level of care, but discharged home; women whose babies were still alive; women who had spent at least eight hours and not more than twelve hours in the midwife obstetric unit and women older than 18 years of age. Purposive sampling was used. The researcher conducted semi-structured one-on-one interviews which were captured by means of an audio-tape recorder to collect data. Taking field notes was part of the interview session. Analysis of data was done according to Tesch’s method of data analysis. The supervisor and an independent coder assisted with the analysis to confirm the data and help develop themes. To ensure rigour in the study, the Lincoln and Guba model of trustworthiness was used, which encompasses truth value, applicability, consistency and neutrality. The research was done in an ethical manner whereby autonomy and respect, beneficence, non-maleficence and justice were maintained by the researcher. The researcher maintained privacy and confidentiality by numbering the interviews and not revealing the participant’s identity. The collected data was kept under lock and key and was only discussed with the research supervisor and the independent coder. The interviews were conducted in a private and safe place without any interruptions. Two main themes emerged from the data analysis. Theme one – A birth before arrival at the midwifery facility is an emotional experience for the mother. Theme two - Mothers described diverse experiences related to emergency childbirth care. Based on the findings of the study, the relevant recommendations were made to improve the overall management of women who experience birth before arrival. The recommendations will be utilised by the midwives in maternity units and primary health-care practitioners in the clinics attending to pregnant women.
- Full Text:
- Date Issued: 2016
Optimizing aspects that facilitate skill acquisition in private dialysis units
- Authors: Fourie, Claire
- Date: 2016
- Subjects: Nephrology , Kidneys -- Diseases -- Nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/6106 , vital:21040
- Description: Nephrology nursing requires a specific set of clinical skills and knowledge. When a professional nurse with no previous dialysis experience enters the field of nephrology nursing he or she has no nephrology related paradigms from past experiences to use as a point of reference. As a result of the rapid growth of the private dialysis company experienced over the past 10 years, many management and support service positions became available. Internal promotions resulted in the movement of experienced professional nurses from the clinical field into management and support services positions, resulting in a sudden loss of skilled individuals from the clinical field. To mitigate this effect, a training intervention was started. The newly appointed managers were all required to work in the clinical field for sixteen hours per month to expose the less experienced professional nurses to the more experienced professional nurses in order to assist them with skill acquisition thus enabling the advanced beginner and competent nurse to become a proficient nurse and/or an expert in the field of nephrology nursing. Experiential learning is not a spontaneous process but depends on many factors that could either hinder or facilitate skill acquisition. This study aimed to explore and describe the aspects that facilitate or hinder skill acquisition during the training intervention that was implemented in private chronic haemodialysis units and to write guidelines to optimize skill acquisition during the training intervention. The study followed a quantitative, descriptive, exploratory, contextual, survey design. Data was collected using a tool based on the theory of nursing accompaniment by Kotze, Kolbs theory on experiential nursing, a framework of strategies that facilitate skill acquisition by King and a generalized tool, the Learning Transfer Skills Inventory (LTSI) that was developed by Holton and Bates to measure learning transfer and factors that contribute and hinder training interventions. Data was analysed with the support of a statistician. The findings were reported and discussed in relation to the current literature. Measures were put in place to ensure validity and reliability, and ethical principles were adhered to throughout the study. Guidelines to optimize skill acquisition were developed. The limitations of the study were the sample size and the response rate. There was a paucity in existing research regarding skill acquisition in Nephrology nursing and limited statistical variance amongst the aspects that facilitate or hinder skill acquisition. It is recommended that the guidelines be implemented to measure the impact they have in the organization.
- Full Text:
- Date Issued: 2016